Diverticulitis

Diverticular disease was first described in the early 20th century[1] but was rarely encountered at that time. Since then, the prevalence of this disease increased from 5%-10% in 1930[2] and to 35%-50% in 1969 according to an autopsy series[3]. No subsequent population-based studies have been reported. At this point, the etiology and disease course of this disease have been sufficiently well researched to allow for diagnosis and treatment of this condition. However, due to the lack of research evidence, treatment options are not well defined. For example, many patients presenting with acute diverticulitis are treated conservatively and receive antibiotics as a standard course of care. A recent study, however, has shown that outcomes for patients treated with antibiotics were not significantly different from patients treated with only observation[4]. This suggests that there is considerable room for improvement in our understanding of this disease and optimal treatment plans.

You can have the pouches and not know it. The diverticula are usually painless and cause few symptoms, if any. But you might notice:

Cramping on the left side of your abdomen that goes away after you pass gas or have a bowel movement

Bright red blood in your poop

Diverticulitis symptoms are more noticeable and include severe abdominal pain and fever.

Diverticulitis can be acute or chronic. With the acute form, you may have one or more severe attacks of infection and inflammation. In chronic diverticulitis, inflammation and infection may go down but never clear up completely. Over time, the inflammation can lead to a bowel obstruction, which may cause constipation, thin stools, diarrhea, bloating, and belly pain. If the obstruction continues, abdominal pain and tenderness will increase, and you may feel sick to your stomach or throw up.

Pain, which may be constant and persist for several days. The lower left side of the abdomen is the usual site of the pain. ...

Nausea and vomiting.

Fever.

Abdominal tenderness.

Constipation or, less commonly, diarrhea.

Doctors aren’t sure. Some studies suggest that your genes might play a role.

The pouches on your intestines get inflamed or infected when they tear or become blocked by feces.

If you have more bad germs than good ones in your gut, that might cause it, too.

Your chances of getting diverticulitis rise with age. It’s more common in people over 40. Other risk factors include:

Being overweight

Smoking cigarettes

Not getting enough exercise

Eating lots of fat and red meat but not much fiber

Taking certain kinds of drugs, including steroids, opioids, and nonsteroidal anti-inflammatories like ibuprofen or naproxen

Several factors may increase your risk of developing diverticulitis:

Aging. The incidence of diverticulitis increases with age.

Obesity. Being seriously overweight increases your odds of developing diverticulitis.

Smoking. ...

Lack of exercise. ...

Diet high in animal fat and low in fiber. ...

Certain medications.

If you don’t treat it, diverticulitis can lead to serious complications that require surgery:

Abscesses, collections of pus from the infection, may form around the infected diverticula. If these go through the intestinal wall, you could get peritonitis. This infection can be fatal. You’ll need treatment right away.

Perforation or tearing in the intestinal wall can lead to abscesses and infection because of waste leaking into the abdominal cavity.

Scarring can lead to a stricture or blockage of the intestine.

Fistulas can develop if an infected diverticulum reaches a nearby organ and forms a connection. This most often happens between the large intestine and the bladder. It can lead to a kidney infection. Fistulas can also form between the large intestine and either the skin or the vagina.

Stricture, which happens when the colon narrows in the affected area.

You can prevent diverticulosis and diverticulitis and their complications by eating plenty of fiber, drinking lots of water, and exercising regularly.

Exercise regularly. Exercise promotes normal bowel function and reduces pressure inside your colon. ...

Eat more fiber. A high-fiber diet decreases the risk of diverticulitis. ...

Drink plenty of fluids. Fiber works by absorbing water and increasing the soft, bulky waste in your colon. ...

Avoid smoking.